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Federal Employees Health Benefits Program

2004 Premiums

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2004 FEHB Postal Premium Rates for Illinois

HMO Plans		2003 Total Biweekly Premium	2004 Total Biweekly Premium	2004 Biweekly Postal Premium Rates
Plan - Option - Enrollment Code		2003 Total Biweekly Premium	2004 Total Biweekly Premium	USPS Pays	Postal Empl. Pays	Change in employee payment
Aetna HealthFund (Consumer Driven Plan)
High Self	221	New Plan	129.44	114.88	14.56	N/A
High Family	222	New Plan	297.73	264.24	33.49	N/A
BlueCHOICE
High Self	9G1	139.61	153.68	136.39	17.29	1.58
High Family	9G2	302.26	332.73	295.30	37.43	3.43
Group Health Plan
High Self	MM1	166.14	197.52	143.32	54.20	17.09
High Family	MM2	358.86	426.63	327.12	99.51	35.35
Health Alliance HMO
High Self	FX1	151.25	169.40	143.32	26.08	3.86
High Family	FX2	353.01	395.37	327.12	68.25	9.94
Humana CoverageFirst (Consumer Driven Plan)
High Self	MW1	New Plan	76.86	68.21	8.65	N/A
High Family	MW2	New Plan	176.77	156.88	19.89	N/A
Humana Health Plan Inc.
High Self	751	134.52	155.99	138.44	17.55	2.42
High Family	752	322.63	358.77	318.41	40.36	4.06
Standard Self	754	102.11	119.60	106.15	13.45	1.96
Standard Family	755	244.89	275.06	244.12	30.94	3.39
John Deere Health Plan
High Self	YH1	124.17	142.23	126.23	16.00	2.03
High Family	YH2	304.21	348.46	309.26	39.20	4.98
Mercy Health Plans/Premier Health Plans
High Self	7M1	174.24	193.54	143.32	50.22	5.01
High Family	7M2	405.29	418.06	327.12	90.94	-19.65
OSF HealthPlans
High Self	9F1	113.59	130.78	116.07	14.71	1.93
High Family	9F2	298.71	343.94	305.25	38.69	5.09
PersonalCare's HMO
High Self	GE1	117.80	137.72	122.23	15.49	2.24
High Family	GE2	303.02	354.10	314.26	39.84	5.75
Unicare HMO
High Self	171	122.22	146.30	129.84	16.46	2.71
High Family	172	350.19	398.16	327.12	71.04	15.55
Union Health Service
High Self	761	107.28	123.70	109.78	13.92	1.85
High Family	762	266.02	306.74	272.23	34.51	4.58

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